| NPI | 1144693565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2015036182) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KS 77043) |
| Enumeration Date | 2015-11-06 |
| Last Update Date | 2015-12-01 |